Updated on October 17th, 2022 // by Katie Griffin
Welcome to the third trimester! This trimester starts in week 28 of your pregnancy and lasts until your baby is born. You may be feeling excited, nervous, or an ever-changing mix of feelings! Let’s learn all about what to expect in this home-stretch of pregnancy.
And if you haven’t caught up with the earlier trimesters (which may still contain a lot of helpful information for you in the third trimester of your pregnancy,) check out our first trimester and second trimester Ultimate Guides.
Estimated reading time: 31 minutes
Table of contents
- Changes in Baby in the Third Trimester of Pregnancy
- Changes in Mom in the Third Trimester of Pregnancy
- Third Trimester Pregnancy Symptoms
- Diastasis Recti
- Stretch Marks
- Round Ligament Pain
- Carpal Tunnel Syndrome
- Shortness of Breath
- Sleep Difficulty
- Restless Legs
- Leaking Breasts
- Back Pain
- Itchy Skin
- Braxton Hicks Contractions
- Varicose Veins
- Swollen Ankles and Feet
- Frequent Urination
- Pelvic Pressure
- High Blood Pressure
- Depression and Anxiety
- To Do
- Finalize Maternity Leave Plans
- Pack Hospital Bag
- Prepare for Breastfeeding or Bottle Feeding
- Get Home Ready for Baby
- Prepare for Diapering
- Shop for Baby Essentials
- Buy and Install a Car Seat
- Make Plans for Other Children
- Choose a Doctor for Baby
- Tour the Hospital
- Start Childbirth Classes
- Write Your Birth Plan
- Exercise, Eat Healthy, & Drink Plenty of Water
- To Avoid
- Doctor Visits in the Third Trimester of Pregnancy
- Call Your Doctor Immediately
Changes in Baby in the Third Trimester of Pregnancy
At the beginning of the third trimester, your baby is around two to two-and-a-half pounds, and around 16 inches long. By the time he’s born, he will be between six and nine pounds and average between 19 and 22 inches long. His brain grows quickly. Cartilage turns into bone. Skin becomes opaque instead of see-through, and fat continues to accumulate. By week 31, all five of his senses are functional.
Movement feels different as your pregnancy progresses. The flutters that you’re used to turn into slower, stronger movements as baby gets bigger and stronger and runs out of room. Some women feel like there is less movement late in pregnancy. If you’re concerned about this, you can usually put your mind at ease by doing a kick count.
During a time of day when baby is usually active (a good time is often after a meal) find a comfortable position and avoid distractions. Count baby’s movements – each kick, wiggle, squirm, etc. Track how long it takes baby to make 10 movements. If baby isn’t moving, she may be asleep. Try waking her with a loud noise, a sweet drink like juice, or some exercise and then get back into a restful position to count. If baby doesn’t move 10 times in 2 hours, call your doctor or midwife. He or she may want to check on baby, or may just want you to continue to monitor movements for a while.
Changes in Mom in the Third Trimester of Pregnancy
You’ll continue to gain weight quickly in the third trimester as your baby grows and your blood volume and amniotic fluid increase. You may gain, on average, around a pound a week. Women who were overweight or obese before pregnancy might gain more like ½ pound a week. Talk to your doctor about your specific situation.
Read more: How Much Weight to Gain During Pregnancy
Hormones — chemicals that act as messengers that tell our bodies how to function — undergo huge shifts again in late pregnancy. Estrogen and progesterone, two of the most important hormones in early pregnancy peak around week 33 and the hormones in your body shift to start preparing for labor. Though that hardworking hormone duo certainly doesn’t clock out altogether! Here are some of the things hormones do in your body in the third trimester of pregnancy:
- As labor approaches, estrogen makes the uterus more sensitive to oxytocin which helps to start labor, and it is also responsible for stimulating your baby’s lungs, liver, and other organs to mature in the womb, helping to prepare baby for life on the outside (1).
- Prostaglandins increase later in pregnancy, encouraging your cervix to soften and ripen in preparation for effacement and dilation. As labor begins, prostaglandins encourage contractions in smooth muscle like the uterus, helping to trigger labor.
- hPL, Human placental lactogen is produced by the placenta. It is one of the pregnancy hormones that helps in the stimulation of milk glands in the breasts, so that your body is ready to provide nutrition to baby after delivery.
- Ocytocin is the hormone responsible for stimulating contractions of your uterus during labor. You have likely heard of its synthetic counterpart, pitocin, which is often used to medically induce labor. Oxytocin is also responsible for the let-down reflex that encourages milk flow during breastfeeding.
Third Trimester Pregnancy Symptoms
Some women experience some abdominal separation during pregnancy. As your baby grows, your muscles thin, weaken, and stretch. Sometimes, the two abdominal muscles that run down the front of your stomach separate, and if the separation is more than three finger widths, it’s called diastasis recti. If you experience back pain from the weakening of your core, you can wear a maternity belt for support. You can also practice pregnancy-safe core-strengthening exercises to help strengthen your abdominal muscles. This won’t necessarily prevent a separation, but strengthening your core can help maintain better posture and reduce back pain. Diastasis recti may correct on its own after pregnancy, and if not, you can do additional exercises at that point.
Stretch marks are caused by skin stretching too quickly for your body to adjust to the growth (2). The collagen and elastin in the middle layer of skin tear or rupture due to the quick change and stretch marks are the resulting scars. During pregnancy, you may get these red, purple, or brown streaks on your belly, breasts, hips, thighs, buttocks, and arms. They’re not harmful but may be itchy. You can help by staying hydrated, using a perfume-free, alcohol-free moisturizer, avoiding chlorine (or showering immediately after activities like swimming,) and avoiding hot showers or baths. There is no way to prevent stretch marks, or make them fade once you have them, but over time they will fade to a silvery color much closer to your natural skin tone.
You may have felt a bit of a reprieve from fatigue in the second trimester, but for most women, it returns in their pregnancy’s third trimester. Your body is carrying the extra weight that you’ve put on as well as baby’s weight, supporting the rapid growth and development of your little one, and you very well may be finding it harder to sleep at night thanks to a combination of frequent urination and finding it hard to get comfortable. Follow the advice we gave in our first trimester article: exercise for 30 minutes most days of the week, eat a healthy diet where you focus on pairing protein and complex carbohydrates in each meal and snack, drink plenty of water, and fit in extra rest when you’re able.
Round Ligament Pain
You may notice pain on the sides of your belly, near your hips. It may feel sharp, sudden, and intense, and happen especially when you do things like cough or sneeze. The culprit is the pulling and stretching of the round ligaments – bands of tissue that support the uterus on both sides. While uncomfortable, round ligament pain is not dangerous. A heating pad on the abdomen may help relieve the pain.
Heartburn, or acid reflux, is caused when stomach acid is regurgitated into the esophagus. It creates a burning sensation in the chest and/or throat and may leave a bad taste in your mouth. The relaxing of the muscles in your body that happens in pregnancy may affect the sphincter that is responsible for keeping acid down where it belongs. And your stomach is under increased pressure from your growing baby, which can force fluid upward. It may help to: avoid fatty and spicy foods; eat smaller meals and snacks rather than 3 large meals; drink small amounts of fluid with meals (remember to get plenty of water overall, though); prop up in a semi-reclined position in bed rather than lying flat.
GERD, or gastroesophageal reflux disease, is acid reflux that happens more often – mild reflux at least twice a week or more severe reflux at least once a week. Follow the tips above. If none of that helps, talk to your doctor. He or she may okay the use of specific antacids or medications.
Carpal Tunnel Syndrome
Pregnancy may cause fluid retention and swelling. Swelling tissues can sometimes press on nerves, and this is what happens in carpal tunnel syndrome. In 25% of pregnancies, compression of the median nerve within the carpal tunnel in your wrist causes numbness and tingling in the hand, near the thumb. Try to avoid repetitive movements that require an angle in the wrist, such as typing. If that doesn’t help, your provider may recommend a splint for your wrists. Fortunately, the symptoms of carpal tunnel syndrome usually go away after you give birth and your fluid levels go back to normal.
You may notice numbness or tingling in your hands, fingers, or toes. As with carpal tunnel syndrome, this is caused by your body’s tissues swelling and putting pressure on your nerves. As with carpal tunnel syndrome, this should go away after your baby is born.
Constipation is common during pregnancy, possibly for a combination of reasons. Increased levels of progesterone can cause the bowels to be sluggish, the growing uterus puts pressure on the intestines, you are likely consuming more iron, such as in prenatal vitamins, and you may be exercising less than normal. There are some things you can do to help combat constipation: drink more water (10 – 12 cups a day); increase your fiber intake by eating fruits, vegetables, and whole grains; exercise regularly, ask your doctor or midwife if you can use a stool softener.
Shortness of Breath
In the third trimester of pregnancy, it is common to experience some shortness of breath. You are carrying extra weight, which would contribute to feeling short of breath in the same way it would if you simply gained weight. There is also increased crowding as your baby grows and your uterus pushes up into everything else. Your lungs are under a bit of a squeeze and are unable to expand as much as normal. And even before baby starts crowding your lungs, pregnancy hormones stimulate your body to increase the frequency of your breaths, which can make you feel out of breath.
It may help to stand or sit as straight as you can to give your lungs a little more room, and to sleep on your left side, which is the best position for circulation. Just let your doctor know if you feel like shortness of breath comes along with weakness, lightheadedness, fatigue, pale skin, or rapid heartbeat or palpitations, as these may be signs of anemia.
As we discussed in our second trimester article, sleep changes are very common in pregnancy. In your third trimester, you may have heartburn, leg cramps, restless legs, shortness of breath, Braxton Hicks contractions, and a bladder that wakes you multiple times a night. And in these last few months, it is increasingly difficult to find a comfortable position.
Your bump makes it impossible to sleep on your stomach now. You shouldn’t sleep on your back because your baby and uterus put pressure on a major vessel that supplies circulation to our baby. And by this point, even just sleeping on your side may not be comfortable enough. You may want to invest in a pregnancy pillow, or experiment with a variety of the pillows and cushions you already have around the house. Also, check out Kopa Birth’s Tips & Comfortable Sleeping Positions During Pregnancy.
One of the more bizarre-seeming side effects of pregnancy is restless legs syndrome. RLS may make a person’s legs feel restless, twitchy, tingly, itchy, creepy-crawly, throbbing, or electric. While it can be hard to describe, sufferers agree that they have an irresistible urge to move their legs, described by some as a physical discomfort and by others as a strong mental urge. The only thing that brings comfort is moving the legs.
To find relief, you can try: walking; massaging your legs; doing leg stretches; taking a warm bath; getting regular exercise, but nothing intense within a few hours of bedtime; avoiding caffeine, alcohol, and tobacco; maintaining a good sleep routine, using a weighted blanket on the legs, or using vibration if you have a chair or massage pad with vibration. The light at the end of the tunnel is that RLS that starts during pregnancy is expected to resolve after your baby is born.
From very early in pregnancy, your breasts have been preparing to feed your baby. You may have noticed increased size and tenderness from the very first weeks of pregnancy. By late in pregnancy, your breasts have begun to produce colostrum, the very first fluid that will nourish your baby with proteins and antibodies, kick-start his immune system, and more. As your breasts fill with liquid, it may sometimes leak. If you experience a little nipple discharge, you can simply use breast pads to absorb the fluid. These pads come in disposable and washable options and you can buy them wherever baby or nursing supplies are sold.
Some women suffer from headaches throughout their pregnancies, and for some, the third trimester brings a new wave, or the first wave. At any point in pregnancy, headaches can be caused by hormone changes, an increase in blood volume, dehydration, high or low blood pressure, pregnancy-related nasal congestion, and stress. The third trimester of pregnancy brings some additional factors that may contribute to headaches – poor sleep, extra weight, and muscle strain from your changing posture.
To help relieve headache pain, start by making sure you’re drinking plenty of water and getting enough rest. You can also try heat or cold on the back of your neck or on your forehead, massage of neck and shoulders, yoga or other stretching exercises, a warm (not hot) shower or bath. If none of that helps, talk to your doctor about whether or not it’s safe in your case to take a pain reliever like Tylenol.
Back pain is a common pregnancy complaint in the third trimester. First, your hormones relax the joints in your body during pregnancy. Then your growing baby bump stretches out and weakens your abdominal muscles, forcing your back to overcompensate for the weakened abs. And as it grows, your bump also shifts your center of gravity, which changes your posture. Here’s an example you can find in Kopa Birth’s Week 18 Pregnancy article:
Think for a moment about the pictures you’ve seen of strong, beautiful women carrying pitchers of water on their heads. The reason they do it that way is because carrying on the head keeps the spine and muscles aligned properly, and is much easier than carrying a load out front. It isn’t the extra weight that’s so hard on a back, it’s the pulling in the wrong direction. Your sweet little pregnant belly is currently providing that wrong-direction pull. To minimize back pain, maintain good posture, continue exercising (consider including some yoga poses that help with back pain in pregnancy, and consider an abdominal support garment or pregnancy belt.
You were most likely screened for anemia at your very first appointment, and this screening will be repeated at around 28 weeks. If you are found to be anemic, your doctor will come up with a treatment plan for you to get at least 17 milligrams of iron a day, from either diet or supplements. An iron-rich diet includes lean beef and pork, organ meats, leafy greens like spinach, dried fruits, beans, whole grains, and nuts.
Nearly 20% of pregnant women experience itchy skin, especially during the last few weeks of pregnancy. As your baby and uterus grow, your skin is increasingly stretched. Use a gentle, high-quality moisturizer and drink plenty of water, to keep your skin hydrated from the outside and inside.
Braxton Hicks Contractions
As you move through the third trimester and closer to your due date, you may experience Braxton Hicks contractions. These are, in a way, practice contractions, because they don’t actually cause changes in your cervix. These contractions feel like a tightening of the uterus in the front of the abdomen (as opposed to real labor contractions that often start as a dull throb in your lower back.) They tend to be irregular, with no pattern (while true labor contractions are regular and they get longer and closer together over time.) And they’ll likely go away if you change your activity level from active to resting or the other way around (while true labor contractions do not go away with a change of activity.) If you’re uncertain of what you’re feeling, it’s always okay to put a call in to your doctor or midwife for advice.
Hemorrhoids – varicose veins that occur in the lower rectum and anus – are common during pregnancy. They can be uncomfortable or even painful. They may cause itching, swelling, stinging, and bleeding, especially during a bowel movement. To prevent hemorrhoids or decrease the discomfort associated with them: avoid constipation by drinking plenty of water and eating a high fiber diet; do Kegel exercises and focus on the muscles around the anus; use witch hazel pads on the hemorrhoids; avoid heavy lifting or straining.
Swollen, bulging veins called varicose veins are common in pregnancy. They may be the result of a progesterone-induced weakening of the walls of your veins, increased blood volume, and increased pressure from your uterus making it harder for blood to flow back upward. If you have varicose veins that hurt or itch, avoid standing for long periods of time, elevate your feet as much as you can, and wear support hose.
Swollen Ankles and Feet
As with varicose veins, circulation changes can cause swelling in your feet and ankles. And you can manage them with the same methods as varicose veins – avoid standing for long periods of time, elevate your feet, wear support hose, and you may even enjoy spending time in a pool, where the pressure of the water presses on your swollen tissues and may reduce swelling (4).
You may have found that the need to run to the bathroom all the time improved during the second trimester, as the uterus rose out of the pelvis and stopped putting so much pressure on your bladder. Frequent urination returns in the third trimester as baby grows, drops lower in your pelvis, and once again puts a lot of pressure on your bladder.
Along with needing to visit the bathroom frequently, you may find that you experience incontinence — little leaks that happen between bathroom visits. Between one third and one half of pregnant women experience stress incontinence (5). Stress incontinence happens when your bladder is under increased stress, and sneezing, coughing, laughing, straining, doing physical activity add additional pressure. Also, your hormones have caused your muscles to relax, including your pelvic floor muscles.
Don’t cut down on your water intake; you need to stay hydrated. Here are some things you can try:
- don’t hold your urine, go when you feel the need to
- try to empty your bladder completely when you go
- avoid becoming constipated which can cause pressure on the bladder
- avoid caffeine
- wear a pad to minimize leaks
- keep doing those Kegels to keep your pelvic floor strong.
Usually within a month of your baby’s birth, he or she will settle deeper into your pelvis, which is known as the baby dropping or lightening. You may feel an increase in pressure on your pelvis, bladder, and hips. Lie down to get some relief when you’re able. Consider getting your exercise by swimming or doing water aerobics, which takes some pressure off. And you may find that a pregnancy support belt is a great help in bracing some of baby’s weight.
Growing a baby is hard work. There’s no easy fix for that. The third trimester of pregnancy is naturally going to bring fatigue. But while they seem to contradict each other, the best solutions are exercise and rest. Regular exercise keeps your body strong and is also good for your mood. However, you will also likely need to rest a little more than you did before you became pregnant. Sit down and put your feet up when your body tells you that you need it.
High Blood Pressure
While some women find that their blood pressure is lower during pregnancy (due to the fact that pregnancy hormones make your blood vessels relax/dilate), some women experience high blood pressure, especially in the third trimester. If you had high blood pressure before you become pregnant, you and your doctor have probably been monitoring and managing it through your first two trimesters, so you should continue your plan. If your blood pressure was normal before pregnancy and starts running high after the 20th week, you have what is classified as gestational hypertension.
This type of hypertension is caused by pregnancy, and it usually goes away after your baby is delivered. High blood pressure usually isn’t a reason for significant concern, but it does mean a greater chance of having a heart attack or stroke, can contribute to organ damage over time, and increases the chances of pregnancy complications like the need for induction or c-section, placental abruption, pulmonary edema, intrauterine growth restriction, low birth weight, premature delivery, and a slight increased risk of stillbirth (6, 7). Work with your doctor to manage your blood pressure, either through diet and exercise or with medication.
The biggest risk associated with blood pressure during pregnancy is preeclampsia. Preeclampsia is a serious high blood pressure condition that can occur during pregnancy (or sometimes after giving birth) that signals that some organs might not be functioning normally. Most of the time, mom and baby make it through delivery healthy, but there is the potential for very serious side effects, so it must be managed carefully. You’re at higher risk for preeclampsia if you:
- had it in a previous pregnancy
- have high blood pressure
- have diabetes
- are obese
- have kidney disease
- have an autoimmune disease
- are pregnant with more than one baby.
If you have mild preeclampsia, you will be monitored closely. If it becomes severe, you may be hospitalized, given meds to control your blood pressure, prevent seizures, and speed up baby’s lung development. And ultimately, the decision may be made that your baby needs to be delivered, even if it’s early.
Call your doctor right away if you have any of these symptoms, which may signal preeclampsia (8):
- changes in vision like blurriness, flashing lights, seeing spots, or being sensitive to light
- headache that doesn’t go away
- nausea, vomiting or dizziness
- pain in the upper right belly area or in the shoulder
- sudden weight gain (2 to 5 pounds in a week)
- swelling in the legs, hands or face
- trouble breathing
Some women find that they’re extra clumsy during pregnancy. Your body has changed so much in such a short period of time that it’s not surprising that you’d be a little clumsier. You don’t innately know where your center of gravity is, how to balance this new shape, etc. There really isn’t a way to fix this, but be aware of it and be extra careful. Now is not the time to try new yoga poses, wear high heels, or spend time up on a ladder.
Many women find that they have an extra burst of energy in the final days or weeks of pregnancy and a strong urge to get everything ready before the big day. Feel free to take advantage of this burst of energy, but be sure not to drain yourself too much; you’ll need stamina for labor and delivery. And don’t take on projects that will require more than a few hours. If baby decides to show up early, or you need to spend your final days or weeks on bed rest, you don’t want to have all of your closets emptied out.
Depression and Anxiety
For the most part, each Kopa Birth trimester-specific Ultimate Guide presents new information that is relevant to the current trimester. However, this is so important that we want to repeat what we’ve said in our previous guides.
Beyond regular pregnancy mood swings – fleeting emotions that come and go – some women experience excessive depression and/or anxiety in pregnancy. Again, this is absolutely normal. Some women feel guilty if they’re not 100% happy all the time when pregnant. But feeling sad or anxious does not mean that you’re not excited about your pregnancy or that you’re not feeling the way a pregnant woman “should.” Pregnancy brings huge life changes, and while they may feel exciting, they may also (even at the same time) feel overwhelming, scary, and stressful. You may worry about your health or that of your baby, about the financial impact of a new baby, about how your relationships will change, about what kind of parent you’ll be.
Not only are you not alone, you’d probably find that nearly every pregnant woman would tell you she’s had the same emotions. And even if you are struggling a bit more than it seems some other people might be, it’s still not uncommon. 20 – 25% of the overall population struggles with mental health challenges (most commonly, depression and/or anxiety), so it makes sense that you’d see similar numbers in the pregnant population. Perhaps even more, since it’s such a stressful time in your life. Talk to your doctor if you’re struggling. I assure you that they hear it often and won’t be surprised or put off by it.
Finalize Maternity Leave Plans
Be sure you know what kind of benefits your employer provides. Communicate with your boss and coworkers about your expected timeline. Wrap up any projects you’re trying to finish. Hand off any assignments that will need to be transferred to someone else.
Pack Hospital Bag
Start with our 10 Birth Hospital Bag Essentials article. These are items that you’ll want to have with you for labor. You also may want to bring:
- several changes of clothing for you
- at least one nursing bra if you plan to breastfeed
- several changes of clothing for your partner
- at least a going home outfit for your baby
- toiletries (hair brush, regular and/or dry shampoo, toothbrush and toothpaste, deodorant, lip balm, extra hair ties, face wipes and/or baby wipes in case you don’t feel like a shower right away)
- an extra-long phone charging cord
- lots of healthy snacks because not all hospitals have food available at all times, and you may find yourself ravenous
Prepare for Breastfeeding or Bottle Feeding
Do your research. Talk to others, if you want input from moms who have been there. Purchase the things you’ll need to support your choice. (Bottles, nipples, formula, bottle brushes, etc. Or nursing bras, nipple cream, nursing pads, possibly a nursing pillow, etc.)
Get Home Ready for Baby
Whether your little one will have his or her own room or share with you or an older sibling, you’ll need to figure out where baby’s stuff will go. Babies don’t need a great deal of stuff, so if your finances and/or space are limited, don’t feel like you need every product marketed toward new parents and babies. If your little one will have his or her own room, you may enjoy the process of picking out colors, furniture, and accessories. If baby won’t have a dedicated space at first, you can still enjoy finding a bassinette or co-sleeper if you intend to use one, and a small dresser in which to store precious, tiny clothes.
Prepare for Diapering
Decide whether you’ll use cloth or disposable diapers, and get a starter stash in newborn size, along with baby wipes. And a recommendation from some parents who use cloth diapers is to buy one small pack of disposable diapers to use in the first days. Meconium can be difficult to wash out of your brand new cloth diapers. And some cloth brands whose diapers are made to fit a wide range of sizes have a hard time fitting the newest of little ones.
Shop for Baby Essentials
Layette is a word that refers to the clothing and linens a newborn will need. There are many layette lists online that can give you an idea of what you might need before your little one arrives. On the other hand, some parents prefer to buy just a few things and see what they actually like and will use before buying any more. You’ll probably want to have at least:
- half a dozen or so onesies or other soft, comfortable outfits
- a few one-piece pajamas or gowns
- half a dozen pairs of socks
- one or two soft hats, especially in cooler weather
- a few baby washcloths
- a soft hooded towel or two
- a package of burp cloths
- a few receiving blankets
- baby nail clippers
- a nasal aspirator
There are an endless number of additional things you could buy, but if you start here, you should have what you need to for the early days.
Buy and Install a Car Seat
Decide if you want an infant-only car seat or a convertible style. The infant-only style can be convenient because they can typically be detached from the base and carried, which can make it easy for baby to have a place to rest when you’re somewhere other than home. A convertible style doesn’t come out of the car for easy carrying, but it will grow with your baby for several years. Research what will work well with your vehicle, especially if you have a small vehicle or will have multiple car seats installed at once.
Make Plans for Other Children
If you have other children, plan who will watch them while you’re at the hospital. Make a plan for whether the person will come to your house, if your children will need to be dropped off somewhere, and plan a backup person if possible, in case your planned caregiver is unavailable at the moment you need to go.
Choose a Doctor for Baby
Interview pediatricians, ask for recommendations from friends or family, and choose a doctor by week 34 or so.
Tour the Hospital
This way it will be familiar when it’s time to have your baby. Figuring out where to park, where to check in, etc. can feel stressful if you’re doing it for the first time when you’re in labor. It also helps to know what kind of labor tools and accessories are available at the hospital, so you’ll know what you might want to bring.
Start Childbirth Classes
You may have chosen childbirth classes in the second trimester, but if you haven’t done that already, no worries. We’ve got a number of resources to help you choose the class that’s right for you. Once you know which classes are right for you, check how long they run, and that will tell you when to start. Our best advice for when to take childbirth classes is to finish between one and two months before your due date.
Write Your Birth Plan
You may have heard that doctors don’t always like birth plans, but we believe that your healthcare team wants you to have an amazing birth experience, and that a birth plan is a great way for you to let them know what that means to you. Some great pointers to get you started are:
- keep it positive, stating your preferences but not as demands (a list of bold “don’ts” is exactly why some providers have a bad taste for birth plans)
- think of it as a birth preference – childbirth is unpredictable and there’s no way to plan for how it will go; you’ll need to be flexible
- be brief – no more than one page, because your team is busy and you want them to actually read it
- avoid impersonal templates, instead focus on including what it most important to you
- share it early – bring it to your prenatal appointments and talk to your doctor rather than just presenting it for the first time during labor
Exercise, Eat Healthy, & Drink Plenty of Water
It’s important that you stay healthy by continuing to exercise, choose healthy foods, and stay hydrated. We’ve discussed in our first and second trimester articles how these things help you stay healthy and help baby develop, but in the third trimester of pregnancy, there’s a new angle. All of these things help you prepare for the marathon of labor. Being strong and fit with strong core muscles will help you do the hard work of bringing baby into the world. And keeping your body nourished and hydrated ahead of time is much easier than trying to eat and drink during labor, when many women feel nauseated and don’t feel much like eating or drinking.
The list of things to avoid stays the same throughout pregnancy, as the following are unsafe for your baby at any stage of development:
Smoking (this includes vaping and all forms of smoking) and drinking alcohol.
Taking any illegal drugs or any over-the-counter or prescription medications that were not specifically prescribed for you during this pregnancy and discussed with your doctor.
Certain foods that are more likely than others to carry bacteria and toxins that could make you sick or harm your baby. This includes raw sushi, cold cuts, raw eggs, unpasteurized dairy, and unwashed produce.
Hot tubs, saunas, and hot baths or showers. When your body temperature rises, so does your baby’s, but his or her temp takes much longer to come down. The prolonged rise in temp could cause baby to develop neurological disorders like seizures.
Scooping cat litter. Have someone else do it if possible, and wear gloves if you must do it. Cat feces may contain a parasite that causes toxoplasmosis.
Gardening without gloves. Toxoplasmosis may also be present in soil, so you shouldn’t garden with bare hands while pregnant.
Spray painting, because of the possibility of inhaling paint particles or chemicals. And if you do paint (other than spray paint), it’s best to use low-VOC or no-VOC paints, wear gloves, and make sure there’s plenty of ventilation.
Flying after 32 weeks. This is the only new addition to the list from the second trimester. Most doctors agree that you shoudn’t fly after week 32 of pregnancy. If something urgent comes up, talk to your doctor about whether it’s okay for your specific situation.
Doctor Visits in the Third Trimester of Pregnancy
You’re an old pro at these visits by now. For the most part, visits will continue to look the same as they have through the second trimester.
If you’re having a normal, low-risk pregnancy, you’ve probably had monthly appointments so far. In the third trimester of pregnancy, appointments change from monthly to every two weeks. And once you pass week 36, they become weekly visits.
Group B Strep Test
Group B Streptococcus is a bacteria that is commonly found in the digestive and reproductive tracts of healthy men, women, and children. Around 25% of pregnant women carry it in their rectum or vagina (9). But while it typically causes no problems for adults or children, it can be harmful for a newborn. Baby can become infected with GBS when he passes through the birth canal. For this reason, all moms are tested for Group B Strep in weeks 35 – 37 of pregnancy. If mom is positive, she will be given antibiotics during labor.
Learn More: GBS: Group B Streptococcus in Pregnancy
An anemia screening, which was done at the beginning of your pregnancy, is usually done again at your 28-week appointment. If tests show that your hematocrit (proportion of red blood cells in your blood) is lower than 3 and your hemoglobin is under 12, you may be diagnosed with anemia.
Starting around the beginning of the trimester, your doctor or midwife will start feeling your abdomen to check baby’s presentation (which part of the baby is over the cervix). By week 34, most babies are in a vertex, or head-down, position. If your baby has not settled into this position, he or she is considered breech. If you make it to the last few weeks of pregnancy with baby still in a breech presentation, your doctor will talk about options like turning the baby by external cephalic version and delivering the baby by cesarean section.
Checking the Cervix
In the last month of pregnancy, your doctor will perform an internal exam (or at least offer to) at each appointment to see if your cervix has begun to efface and dilate yet.
Call Your Doctor Immediately
If you have any of the following symptoms, call your doctor or midwife immediately:
- vaginal bleeding
- painful cramping/severe abdominal pain
- severe diarrhea
- severe vomiting
- high fever
- pain when urinating or trouble urinating
- severe headache
- sudden swelling of hands/face
- vision disturbances
- rupture of membranes (water breaking)
You wait and wait for all of those long months, and finally the time comes. Though it doesn’t usually come in with a bang. More often, you spend some time wondering if it’s really the real thing. Let’s talk about signs to look for.
These things indicate that your cervix is probably changing. It may progress right into labor or it may still be days or weeks away.
- nonprogressing contractions – occur regularly and may continue for hours, but don’t change in intensity, frequency, or duration; likely mild and 8 to 20 minutes apart
- bloody show – this thick mucus that plugs your cervix may loosen and be released when the cervix begins effacing and dilating; this passes as what typically looks like blood-tinged mucus; it may happen before any other labor sign or not until hours after contractions have begun
Possible Signs of Labor
These changes occur late in pregnancy and may indicate that hormonal changes are underway, but don’t indicate changes in the cervix. They can occur for days or weeks without progressing to labor.
- mild to moderate abdominal cramping – may feel similar to menstrual cramps and may come with discomfort in your thighs
- restless back pain that comes and goes; this isn’t a pain like sore muscles, it feels more like the pain you might feel before your period, and often comes with a feeling of uneasiness or restlessness
- diarrhea or soft bowel movements; this may be due to an increase in prostaglandins, which cause your lower digestive tract to clear itself
- nesting urge; you may feel a sudden burst of energy and desire to get your “nest” ready
Positive Signs of Labor
- progressing contractions; these contractions dilate your cervix; they become longer, stronger, more frequent, and over time they become harder to manage
- rupture of membranes (water breaking); some pregnancies begin with ruptured membranes but it often doesnt happen until the active phase of labor; this may feel like a gush of water, as if you’d wet yourself; note the time, the color and odor of the fluid, and notify your doctor or midwife
- changes in your cervix confirmed by vaginal exam
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